The Real Danger in 'A Civil Action'

Project to promote the public health system with the media

From 1998 to 1999, Pyramid Communications, Seattle, conducted media outreach effort promoting an efficient and effective public health system. The effort centered around the nationwide release of the movie, A Civil Action.

The book on which the movie was based focused on a lawsuit brought by families in Woburn, Mass., for environmental pollution allegedly linked to a cluster of cancers in the community. The movie, while focusing on the plaintiffs' lawyer's story, also focused on the environmental health risks, not the public health system as a whole.

This project addressed concerns within RWJF's Turning Point program — a national program to promote the reorganization of state and local public health agencies — that the film's extensive media coverage would neglect the issue of broader, system-wide efforts to change public health agencies.

The attention created by this film presented an opportunity to educate the media about the modern threats to public health.

Key Results

  • Working with staff at the Turning Point national program office, Pyramid conducted extensive research in four areas of public health:
    • Tuberculosis.
    • Hepatitis A.
    • E. coli.
    • Waterborne disease.

    They compiled statistics in four states selected as key to this effort — Virginia, Illinois, Oklahoma, and Louisiana.

    Pyramid researched general public health statistics nationally through the:
    • Centers for Disease Control and Prevention (CDC).
    • The Association of State and Territorial Health Officials (ASTHO).
    • The Agency for Toxic Substances and Disease Registry (ATSDR), part of the U.S. Department of Health and Human Services (DHHS).

    Pyramid also identified experts in the public health field to speak about each of the four health areas in the four states.
  • Pyramid developed an outreach packet (press kit) that included:
    • A cover letter.
    • A public health background piece.
    • A list of key messages and talking points for Turning Point representatives and reporters.
    • A series of op-ed pieces.
    • An action guide (designed to be useful beyond the Civil Action campaign).
    • A glossy ad for placement in newspapers and newsletters.
    • Letters to the editor tailored for specific audiences and publications in all 14 Turning Point states.
    • Press materials and state-specific examples of the four targeted states describing real-life cases of public health incidents occurring within the past four years.

    After identifying target media outlets in print, radio, and television, Pyramid distributed press kits to approximately 500 reporters and faxed an abbreviated version of the packet to 500 more. A press release was placed on HealthWire, a specialized news source used by Business Wire, a large, national source for news release dissemination.

    Although 1,000 reporters were provided with the press kits, few indicated a wish to feature this angle exclusively and many expressed only mild interest in the op-ed piece.

    Many reporters and radio personalities said they would keep the press kit on file for future stories. The Turning Point projects found the outreach packets useful for work with their state coalitions. (See the Bibliography for media coverage.)
  • Finding a high level of skepticism among public health officials about media interest in public health and a reluctance to take a proactive approach to the media, Pyramid recommended:
    • A media or presentation-skills training program to help Turning Point grantees become more comfortable in a proactive relationship with reporters.
    • The strengthening of relationships between state public health agencies and Turning Point grantees.


RWJF supported the project with a grant of $74,786 between December 1998 and January 1999.